New strategy for the treatment of type 2 diabetes mellitus with incretin-based therapy
- 1k Downloads
Incretin-based therapy was first made available for the treatment of type 2 diabetes mellitus (T2DM) in the US in 2006 and in Japan in 2009. Four DPP-4 inhibitors and two GLP-1 analog/receptor agonists are currently available. The effects of incretin-based therapy are assumed to be exerted mainly through the hormonal and neuronal actions of one of the incretins, GLP-1, which is secreted from L cells localized in the small intestine. The benefits of this therapy over conventional sulfonylureas or insulin injections, such as fewer hypoglycemic events and reduced body weight gain, derive from the glucose-dependent insulinotropic effect. The protective effects of this therapy on vulnerable pancreatic β-cells and against micro/macroangiopathy in T2DM are also most welcome. Indications and/or contraindications for incretin-based therapy should be clarified by prospectively studying the experiences of Japanese T2DM patients undergoing this therapy in the clinical setting.
KeywordsIncretin GLP-1 GIP DPP-4 inhibitors GLP-1 analog/receptor agonists
- 1.The Japan Society of Dialysis Therapy. http://docs.jsdt.or.jp/overview/pdf2012/p15.pdf.
- 5.Miuchi M, Miyagawa J-I, Konishi K, Nagai E, Matsuo T, Murai K, Katsuno T, Hamaguchi T Namba M. Morphologic changes of α-cells in the pancreas of Japanese non-obese type 2 diabetes (oral presentation). In: 3rd Scientific Meeting of the Asian Association for the Study of Diabetes. Tokyo: AASD; 2011.Google Scholar
- 11.Kodera R, Shikata K, Kataoka HU, Takatsuka T, Miyamoto S, Sasaki M, Kajitani N, Nishishita S, Sarai K, Hirota D, Sato C, Ogawa D, Makinjo H. Glucagon-like peptide-1 receptor agonist ameliorates renal injury through its anti-inflammatory action without lowering blood glucose level in a rat model of type 1 diabetes. Diabetologia. 2011;54:965–78.Google Scholar
- 12.Ishibashi Y, Nishino Y, Matsui T, Takeuchi M, Yamagishi S. Glucago-like peptide-1 suppresses advanced glycation end product-induced monocyte chemoattractant protein-1 expression in mesangial cells by reducing advanced glycation end product receptor level. Metabolism. 2011;60:1271–7.PubMedCrossRefGoogle Scholar
- 13.Katsuno T, Kusunoki Y, Tokuda M, Murai K, Ochi F, Miuchi M, Hamaguchi T, Miyagawa J-i Namba M. Strict glycemic control in Japanese type 2 diabetes patients with incretin-based therapy—efficacy of continuous glucose monitoring for the secure transition and fine tuning. Infusyst Asia. 2012;7(1):6–8.Google Scholar
- 15.Vincent SH, Reed JR, Bergman AJ, Elmore CS, Zhu B, Xu S, Ebel D, Larson P, Zeng W, Chen L, Dilzer S, Lasseter K, Gottesdiener K, Wagner JA, Herman GA. Metabolism and excretion of the dipeptidyl peptidase 4 inhibitor sitagliptin in humans. Drug Metab Dispos. 2007;35:533–8.PubMedCrossRefGoogle Scholar